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将口服磺脲类降糖药血糖控制不满意的2型糖尿病患者96例随机分为治疗组和对照组各48例,治疗组在磺脲类降糖药物的基础上加服吡格列酮30mg,1次/日,对照组加服二甲双胍0.5g,3次/日,疗程均为3月,比较治疗前后两组的空腹血糖(FPG),餐后2h血糖(2hPG),糖化血红蛋白(HbA1c),空腹胰岛素(FINS),餐后2h胰岛素(2hINS),稳态胰岛素评价指数(HOMA-IR),体重指数(BMI),低密度脂蛋白胆固醇(LDL-C),甘油三脂(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C)的变化。结果两组治疗前FPG,2hPG,HbA1c,FINS,2hINS,HOMA-IR,BMI,TG,TC差异无统计学意义,治疗后与治疗前比较,两组FPG,2hPG,HbA1c,FINS,2hINS,HOMA-IR,BMI,LDL-C,TG,TC均显著降低,差异有统计学意义;而治疗组与对照组相比,FPG,2hPG,HbA1c,FINS,2hINS,HOMA-IR,LDL-C,TG降低更为明显,并有HDL-C升高,差异有统计学意义。结论吡格列酮治疗2型糖尿病不但能改善胰岛素抵抗,降低血糖,还能改善脂质代谢紊乱,延缓糖尿病的发展及降低发生血管并发症的危险,从而改善患者的远期预后,治疗过程中无明显不良反应,值得临床推广应用。
Ninety-six patients with type 2 diabetes who were not satisfied with oral administration of sulfonylurea hypoglycemic agents were randomly divided into treatment group (n = 48) and control group (n = 48). The treatment group was given pioglitazone 30 mg on the basis of sulfonylureas, / Day, the control group plus metformin 0.5g, 3 times / day, the course of treatment were March, before and after treatment compared fasting blood glucose (FPG), 2h postprandial blood glucose (2hPG), HbA1c, fasting insulin FINS, 2hINS, HOMA-IR, BMI, LDL-C, triglyceride (TG), total cholesterol TC), high-density lipoprotein cholesterol (HDL-C) changes. Results There were no significant differences in the levels of FPG, 2hPG, HbA1c, FINS, 2hINS, HOMA-IR, BMI, TG and TC between the two groups before and after treatment IR, BMI, LDL-C, TG, TC were significantly decreased, the difference was statistically significant; while the treatment group compared with the control group, FPG 2hPG HbA1c FINS 2hINS HOMA-IR LDL-C TG Reduce more obvious, and HDL-C increased, the difference was statistically significant. Conclusion Pioglitazone can not only improve insulin resistance and reduce blood sugar, but also improve the lipid metabolism disorder, delay the development of diabetes and reduce the risk of vascular complications, so as to improve the long-term prognosis of patients with no obvious adverse drug treatment Response, it is worth promoting clinical application.